SURGICAL VARIABLES AFFECTING SPEECH IN TREATED PATIENTS WITH ORAL ANDOROPHARYNGEAL CANCER

Postoperative speech function may be influenced by a number of treatme nt variables, The objective of this study was to examine the relations hips among various treatment factors to determine the impact of these measures on speech function. Speech function was tested prospectively in 142 patients with surgically treated oral and oropharyngeal cancer 3 months after treatment, Each patient's speech was recorded during a 6- to 7-minute conversation and while performing a standard articulati on test, producing speech outcome measures of percent correct consonan t phonemes and percent conversational understandability. Correlational analyses were used to determine the relationships among the speech ou tcome measures and 14 treatment parameters. Speech function was mildly to moderately negatively correlated with most surgical resection vari ables, indicating that larger amounts of tissue resected were associat ed with worse speech function. Overall measures of conversational unde rstandability and percent correct consonant phonemes were related to e xtent of oral. tongue resection, floor of mouth resection, soft palate resection, and total volume of tissue resected, These relationships v aried depending on the method of surgical closure. Method of surgical reconstruction had a profound impact on postoperative speech function 3 months after treatment and was an important factor in determining ho w oral tongue resection influenced articulation and intelligibility, T he combination of closure type, percent oral tongue resected, and perc ent soft palate resected had the strongest relationship with overall s peech function for patients with surgically treated oral and oropharyn geal cancer 3 months after treatment.